| NPI | 1992361778 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 33821) | 
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: WV 33821) | 
| Enumeration Date | 2019-05-16 | 
| Last Update Date | 2024-08-16 |